{
  "abstract": "Vignette: A premenopausal woman was reviewed for painful vertebral fractures in the context of prednisolone exposure for her newly diagnosed systemic lupus erythematosus (SLE). Known clinical risk factors for bone loss included exposure to depot medroxyprogesterone acetate (MPA) for 12 yr, cigarette smoking, a family history of osteoporosis and ongoing inflammatory arthritis. Initial investigations also identified vitamin D deficiency and low bone mass for age and sex. She was treated with vitamin D, and her contraception was changed to a levonorgestrel intrauterine device. In the context of further vertebral fractures confirmed with both MRI and bone scan and having had additional secondary causes of low bone mass excluded, she commenced targeted osteoporosis treatment. We discuss the complexities of managing bone fragility in young adults and the impact of depot MPA, inflammatory disease (SLE), and glucocorticoid-induced osteoporosis (GIO) on younger adults. In this woman, antiresorptive therapy with zoledronic acid was recommended; we also explore the existing evidence-base for antiresorptive and anabolic therapies in younger adults, with a particular focus on GIO.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Madhuni Herath"
    },
    {
      "name": "Hanh H Nguyen",
      "orcid": "0000-0002-8846-6168"
    },
    {
      "name": "Frances Milat",
      "orcid": "0000-0002-9940-4376"
    },
    {
      "name": "Peter R Ebeling",
      "orcid": "0000-0002-2921-3742"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4qhb0sgfewdby.bib",
  "cited_by": 0,
  "doi": "10.1093/jbmr/zjag088",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13716917/",
  "id": "4qhb0sgfewdby",
  "issns": [
    "0884-0431",
    "1523-4681"
  ],
  "landing_url": "https://doi.org/10.1093/jbmr/zjag088",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00010"
    ],
    [
      "heading",
      "AcademicSubjects/MED00160"
    ],
    [
      "heading",
      "AcademicSubjects/MED00250"
    ],
    [
      "heading",
      "Complex Clinical Challenges"
    ],
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7162191318",
  "pdf_url": null,
  "pmcid": "PMC13716917",
  "pmid": "42176199",
  "published": "2026-05-23",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/4qhb0sgfewdby.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T12:21:20Z",
      "native_id": "PMC13716917",
      "source": "pmc",
      "url": "https://doi.org/10.1093/jbmr/zjag088"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Vertebral fractures in a young woman: the impact of hypogonadism, glucocorticoids, and chronic disease",
  "title_text": "Vertebral fractures in a young woman: the impact of hypogonadism, glucocorticoids, and chronic disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:20Z",
  "url": "https://research.draconitic.com/paper/4qhb0sgfewdby",
  "venue": "Journal of Bone and Mineral Research",
  "versions": []
}